Tag Archives: bulimia nervosa

Eating disorders like anorexia nervosa and bulimia nervosa are difficult psychiatric disorders. They are especially tragic because, while they may seem like just messed up eating, they are far, far more. Eating disorders have some of the highest rates of death of any psychiatric disease, as malnutrition puts the body at risk.

When we think of eating disorders, though, we tend to think of them from a cultural angle. It’s because our culture is so obsessed with thin, no one can ever be thin enough, and so that must bring out eating disorders. It is true that a culture which glorifies skinny the way ours does tend to bring out more extreme dieting than one that does not. But it is also true that eating disorders are far more than the product of a culture which glorifies the size 0. Reports and descriptions of anorexia, for example, date all the way back to the Greeks, and famous case studies that fully described the disorder date from the 1860’s. There is clearly a genetic component, anorexia in particular runs strongly in families. There is also a potential sex effect, eating disorders are far more common in women than in men.

Eating disorders are a combination disease, a combination of genetic risks and environmental triggers, including things like stress. Unfortunately, it’s been difficult to identify specific genes that predispose people to eating disorders. Studying large populations of people with the disease and find some common genetic variants, for example, but for such a complex disorder that is not dependent on a single gene, many of those will also be present in healthy populations.

Another approach is instead to look at families which have a strong history of eating disorders, to see what common genes are passed down. While this has its own limitations (for example, you then have to look for the occurrence of those genes in the wider population, and being within a single family or two, there are bound to be environmental factors that aren’t present elsewhere), it’s a way to uncover genetic variants that my have previously gone undiscovered. And it means you might, as they did here, uncover two genes that, when screwed up in very precise ways, result in the same eating disorder.

This is another post in Sci’s investigation into the current studies being performed on eating disorders, particularly binge eating and bulimia. Usually I try to focus on the dysregulation of reward-related systems in these disorders, but this paper will be a little different. Faris et al. “De-Stabilization of the Positive Vago-Vagal Reflex in Bulimia Nervosa” Physiology and Behavior, 2008.
It’s kind of in the nature of an eating disorder that there aren’t any really funny pictures or something that Sci can put in here.
So before we go forward, here’s a kitten.

We are now continuing on Sci’s new found, somewhat relentless search into the relationship between eating disorders such as binge eating, bulimia, and anorexia, and reward systems that are usually associated with things like drug addiction.
And today I found a human study that looks a little…interesting. For a lot of reasons. Let’s talk dopamine receptors, shall we?
Editor’s Selection Icon Frank et al. “Increased Dopamine D2/D3 Receptor Binding After Recovery from Anorexia Nervosa Measured by Positron Emission Tomography and [11C]Raclopride” Biological Psychiatry, 2005.
This one’s going to require some background. Let’s talk about dopamine and dopamine receptors.

You all may remember that Sci’s recent posts have focused on eating, overeating, and dopamine. Today, Sci continues this trend. Honestly, she couldn’t stop thinking about it. How is overeating like addiction? How is it different? And so she began to look up a bunch of papers on binge eating and dopamine.
I was particularly interesting in the changes in food intake and reward associated responses in people with eating disorders like bulimia nervosa and anorexia nervosa. There are many hypotheses as to why these eating disorders exist, ranging from problems with society (which can certainly contribute to the incidence of the disorders), to hypotheses of obsessive control akin to the compulsions seen with OCD, to increased sensitivity to reward, to decreased sensitivity to reward.
This increased/decreased sensitivity to reward (some people have seen decreased sensitivity to reward in rats, along with increased self-administration of pleasurable things, but what this actually translates to in humans can be difficult to interpret) was particularly interesting, and so Sci was very glad when she came across this study. Schienle et al. “Binge-Eating Disorder: Reward Sensitivity and Brain Activation to Images of Food “, Biological Psychiatry, 2008.